Usefulness of a nasal jejunal catheter in postoperative management of laparoscopic fundoplication in patients with neurological impairment

Abstract

Purpose: Laparoscopic fundoplication is widely performed for gastroesophageal reflux disease in children with neurological impairment, but postoperative nutritional management may be difficult due to delayed gastric emptying. Therefore, we retrospectively examined the usefulness of a naso-jejunal feeding catheter (NJC) in postoperative management.

Methods: Patients with neurological impairment who underwent laparoscopic fundoplication at our hospital between 2008 and 2018 were divided into two groups based on the presence or absence of use of a NJC. Patient characteristics, nutritional status, postoperative course, and complications were compared in these groups.

Results: Laparoscopic fundoplication was performed with a NJC in 27 patients and without a NJC in 13 patients. The NJC group had a significantly earlier start of enteral feeding (1.0 ± 0.4 vs. 2.7 ± 2.6 days, p = 0.002) and earlier establishment of full enteral feeding (6.1 ± 2.1 vs. 12 ± 6.5 days, p = 0.0002). The rate of perioperative complications was also significantly lower in the NJC group (5/27 (18.5%) vs. 7/13 (53.8%), p = 0.03).

Conclusions: NJC placement in patients with neurological impairment who underwent laparoscopic fundoplication resulted in an earlier start of enteral feeding, earlier establishment of full enteral feeding, and reduction of postoperative complications.